It has been a long month for everyone in the health center community, and we are truly in awe of the hard work and sacrifices endlessly given by health center providers and staff on the front lines of the COVID-19 pandemic. After weeks of negotiations, Congress finally reached agreement on a third emergency stimulus package, known as the CARES Act. The Senate voted unanimously to pass the bill late Wednesday night, and the House of Representatives followed up on Friday afternoon – passing the measure with a voice vote, and sending it immediately to the President who signed it into law.

While the bill did not include everything health center advocates had requested from Congress in the midst of this crisis, it did include several provisions which offer increased flexibility and funding to health centers to help address immediate challenges associated with the COVID-19 response. Here’s a look at some of the major provisions of the bill impacting health centers:

$ 1.32 Billion in Emergency Supplemental Funding for Health Centers

The bill provides $1.32 billion in FY20 for supplemental awards to health center grantees. This builds upon the $100 million already authorized by Congress in the first COVID response bill passed earlier this month. This new funding will be available to aid health center grantees in their response to COVID-19, including needs related to testing, treatment, and maintaining pre-COVID staffing levels during the crisis. HRSA has already stated their intent to get these dollars to health centers as soon as possible, hopefully within two to three weeks.

$100 Billion in Grant Funding to Offset Provider Revenue Losses due to COVID-19

In addition to funds provided for health centers to respond to the COVID-19 pandemic, provisions were also made for grant funding to help cover some of the revenue loss caused by the crisis itself. One hundred billion dollars in grants will be provided to health care institutions, including health centers, on the front lines of the crisis to cover unreimbursed expenses and revenue lost as a result of the pandemic.

Short-Term Mandatory Funding Fix through November 2020

Federal mandatory grant funding for Community Health Centers has been extended from the previous May 22 deadline to November 30, 2020. This six-month extension provides flat funding to the Community Health Center Fund, the National Health Service Corps, and the Teaching Health Centers Graduate Medical Education program. As a result, all health center grantees, Primary Care Associations (PCAs), Health Center Controlled Networks (HCCNs), and National Health Center Training and Technical Assistance Partners (NTTAPs) will receive the full 12-months’ worth of funding for their budget year that began in CY2020.

Improved Telehealth Reimbursement

For the duration of the COVID-19 crisis, health centers and rural health clinics (RHCs) will be authorized for Medicare reimbursement as distant sites in visits provided via telehealth (meaning that FQHC or RHC providers will be paid for telehealth services provided to patients at home.) The reimbursement will not be at the Medicare PPS rate, but rather at payment rates similar to the national average payment rates for comparable telehealth services under the Medicare Physician Fee Schedule. This provision went into effect immediately and guidance from CMS on this payment is expected shortly.

Fully-Forgivable Loans to Cover Payroll and Mortgage Expenses for Health Centers with Less than 500 Employees

The bill provides a total of $349 billion for loan guarantees through the Paycheck Protection Program at the Small Business Administration, which health centers with less than 500 employees can use to cover any aspect of payroll, as well as mortgage, rent, and utility payments. These loans can be used to cover costs incurred between February 15, 2020 and June 30, 2020. All payments will be deferred at least six months, and may be fully forgivable provided that health centers can demonstrate that the funds were used as intended, and that they did not make significant reductions in either the number of employees or wages paid.

Other Provisions of Interest

The bill includes several other provisions which can be helpful to health centers and their patients, including child care funding for health care providers, no-cost sharing coverage for COVID-19 testing, funding for a variety of critical health and social services programs, and specific ways to address PPE needs– among others. To see a full list of these provisions and what they mean for health centers, see NACHC’s breakdown of the bill here.

What’s next for Community Health Centers?

While this legislation will help provide some relief to health centers facing extreme challenges as a result of this pandemic, the unprecedented nature of this crisis means that our work must continue over the coming weeks and months. We will be working with the Administration to ensure the provisions from this third bill are implemented quickly and effectively, while also working with our Congressional partners to advocate for additional legislation in the weeks ahead. While Congressional leaders have already begun to discuss potential items to include in a fourth COVID response bill, the timing of such an effort is uncertain. After passing this bill, both of Congress’ legislative chambers went on recess until April 20, 2020.

We will continue to keep you updated on next steps, and are ready to answer any questions you might have about this legislation at federalaffairs@nachc.org. We are so grateful for the efforts of our advocates and the health center community – all our progress to date is thanks to your dedication to this movement. Please take good care of yourselves and stay safe.

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